Innovation Pharmaceuticals Inc (IPIX)

[Orion Nebula]

I was in Hospital Admin for 35 years until I retired last year. Many people have asked me what I think of the ACA and my answer is always the same. Something had to be done. Is it perfect? No. Can it be modified to make a better system than we have today? Probably. Richard Nixon made the first major overhauls to Medicare and Medicaid that were needed. And it got better. Speaking of Nixon, that old Republican was the first to propose national health insurance. Might have gotten it too if not for Watergate.

The ACA is complex. There are many good provisions. One that my hospital benefitted from was the rapid adoption of a sophisticated electronic medical record. We received millions in government payments for being an early adopter. It cost our hospital over $100 million to put in place so the millions (I think it was $7 million in incentive payments) did not come close to paying for it. But the government got it all back in improved care and the elimination of duplicative care. For instance our lab tests went way down because one MD would order a test another had already ordered and there was not a good way to prevent that. The lab test reduction was $50 million alone.

I suspect there are bad practices that can be fixed like Nixon did with Medicare. But anybody who doesn't think something had to be done better look at the rate of health care inflation over the years. Just abysmal. They are now going down - not health care costs but the rate of health care inflation. And please don't look at infant mortality if you think the existing system is great.

Remember too that anyone without health insurance goes to the ER -where costs are the highest. Mandated by law that they must be seen. So my hope is when the dust settles and those who now go to the ER are seen by a primary care MD and the savings from that switch will offset some of the cost of insuring the uninsured.

One last point - my hospital was 70% Medicare and Medicaid. A lot of so called socialized medicine has been in place for half a century. But under these "socialized" programs you do not get cancelled for a pre-existing condition. There are people on this board who have gone public with their health conditions and under the existing system they better be loaded when there policy comes due. I have seen many people cancelled with the kinds of conditions discussed on this board.

Not easy stuff. But simplistic rationales based on half the story don't get us to the kind of health care outcomes we need to see in this country.